COULD PLASMA GLUCOSE (PG) INCREMENT (PG %) EXPAND THE CLINICAL WEIGHT OF OGTT? PRELIMINARY FINDINGS IN 19 TDT PATIENTS (Β-TDT) WITH NORMAL GLUCOSE TOLERANCE Plasma glucose (PG) increment (PG %) and pancretic β-cell dysfunction in thalassemia
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Abstract. Background: Worldwide, glucose dysregulation (GD) and diabetes mellitus are common complications in transfusion-dependent β-thalassemia (β-TDT) patients. Impaired insulin sensitivity and insulin secretion are both involved in the deterioration of glucose tolerance from normal to a glucose-intolerant state.
Objective: The main aim of the present study was to evaluate retrospectively the plasma glucose (PG) increment (PG %) at 2-h during oral glucose tolerance test (OGTT) over fasting plasma (FPG) concentration as a simple parameter to recognize early β -cell dysfunction in normoglycemic β-TDT patients with NGT and different severity of IOL.
Patients and Methods: A total of 19 β-TDT young adult patients with normal OGTT were re-evaluated. OGTT was performed according to the American Diabetes Association (ADA) guidelines. Venous blood samples were collected at baseline and 30', 60' and 120' minutes to determine PG (mg/dL) and insulin concentrations (μIU/mL). The time required for the PG concentration to return to the fasting level was made by computing the percentage increment of 2-h PG in respect to FPG (PG%), using the formula [(2-h PG-FPG)/FPG]x 100. The early phase of insulin secretion (IGI) and sensitivity were assessed by validated surrogate indices calculated from parameters obtained during the four point OGTT.
Results: The mean age of patients was 30.3 ± 5.7 (range:23.10-44.3). The mean ± SD, median and range of PG% increment, between 2 h-PG and FPG, was 35.5 ± 20.2 , 38.7 and 0 - 68.2, respectively. The PG% increment was negatively correlated to patient's age, FPG and IGI, and positively correlated with 2-h PG post-glucose load. IGI was negatively correlated with 1-h and 2-h PG after post-glucose load and positively correlated with oral disposition index (oDI).
Conclusions: In conclusion the PG% is a simple useful screening parameter that can expand the clinical weight of OGTT and can provide valuable metabolic information on β-cell dysfunction.
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